We had experienced a case of Waldenstrom's macroglobulinemia in 45-year-old man,
who visited the outpatient department of internal medicine due to bleeding diathesis of
nose and gum, multiple lymphadenopathy, and general fatigue. Physical examination
revealed mild hepatosplenomegaly and generalized lymphadenopathy. Serum protein
electrophoresis shows the monoclonal gammopathy at the late beta-fraction. By the
immunoelectrophoresis of serum protein, IgM, lambda-type macroglobulinemia was
confirmed. Bone marrow smear and biopsy shows 61Th of plasmacytoid lymphocytes,
atypical lymphocyte and mature and immature plasma cells. Cervical lymph node biopsy
shows obliteration of normal structure by diffuse proliferation of plasmacytoid
lymphocytes and histiocytes in subcapsular sinus, cortex and medulla. PAS positive
intranuclear and intracytoplasmic inclusion bodies were seen in plasmacytoid
lymphocytes. By electron microscopic findings of cervical lymph node, dilated rough
endoplasmic reticulum which was filled with electron-light density and pale amorphous
material. Intracytoplasmic and intraunclear inclusion bodies containing the same density
material were seen.
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